Riley G F, Lubitz J D
Health Care Financ Rev. 1989 Winter;11(2):1-12.
To study the use of health services before death for different causes, a 6-year file of Medicare use and cost data was linked to a file of death certificate information for persons dying at ages 65 years or over in 1979. Patterns of medical care use during the last years of life varied substantially by cause of death, reflecting the degree of chronicity of the disease that resulted in death and the nature of treatment. Persons dying of nephritis, chronic obstructive pulmonary disease, and diabetes mellitus incurred consistently high expenses for 6 years before death. Costs for cancer decedents were also high, especially in the last 2 years of life. Persons in their last 2 years of life have a considerable impact on Medicare expenses. An estimated 13 percent of annual Medicare expenses were attributable to persons who were within 2 years of death from heart disease and 10.7 percent to persons who were within 2 years of death from cancer.
为研究不同死因患者临终前的医疗服务使用情况，将一份为期6年的医疗保险使用和成本数据文件与1979年65岁及以上死亡者的死亡证明信息文件相链接。临终前几年的医疗护理使用模式因死因不同而有很大差异，这反映了导致死亡的疾病的慢性程度和治疗性质。死于肾炎、慢性阻塞性肺疾病和糖尿病的患者在死前6年的费用一直居高不下。癌症死者的费用也很高，尤其是在生命的最后两年。生命最后两年的患者对医疗保险费用有相当大的影响。估计每年医疗保险费用的13% 归因于距心脏病死亡不到两年的患者，10.7% 归因于距癌症死亡不到两年的患者。
